Updated on September 30, 2024
Hepatitis C is a viral infection with the hepatitis C virus (HCV) that causes inflammation of the liver. There are around 100,000 new cases reported each year in the United States.
HCV is most often transmitted through direct contact with the blood of a person who is infected with the virus. Because hep C infections don’t typically have noticeable symptoms, a person can have a chronic infection for years without knowing it. This can lead to life-threatening complications like cirrhosis (scarring) of the liver, liver cancer, and liver failure.
The good news is that there are effective methods for diagnosing hep C, as well as effective treatments. Currently, more than 90 percent of people who are treated for hep C are cured of the infection.
Learn about the tests that a healthcare provider (HCP) will use when diagnosing the virus. Plus, find out how this testing helps HCPs find the best course of treatment.
Initial screening
The first screening test for hepatitis C is an antibody test that looks for the presence for HCV antibodies (anti-HCV) in the blood. If this test comes back positive, it means that the person has been infected with hepatitis C at some point in their life.
Hep C RNA Test
If the initial screening test is positive, the next step is a follow-up test to determine whether the hepatitis C infection is active. Your HCP will order a test that checks for the presence of hepatitis C virus RNA (the genetic material of the virus). If the RNA test is positive, it means the hep C infection is active.
Between 15 and 25 percent of hepatitis C cases resolve on their own without treatment and without becoming a chronic infection. In cases that require treatment, before you can begin, there are several key pieces of information your HCP will need to know about the infection. These include the virus’s genotype, the viral load, and the health of your liver.
Genotype
Hep C genotypes are different versions of the hepatitis C virus. Just like any living organism, HCV has evolved over time, and these have resulted in seven major hepatitis C genotypes, as well as numerous subtypes within the genotypes. The most common hep C genotype in the United States is genotype 1. Different medicines are more effective at treating different genotypes. Lack of genotype testing results, however, shouldn’t be a barrier to treatment.
Viral load
Before treatment, an HCP will also test for viral load, which is the amount of the virus that is present in the blood. (This is the hep c RNA test, just quantitative instead of qualitative.) Viral load can be useful in predicting how an infection will respond to treatment. It will also be monitored while a person is on a treatment to determine how well a treatment is working. The goal of treatment is to get the viral load to zero, or undetectable in the blood, which means the body has cleared the infection.
While it is usually easier to clear a low viral load, viral load is not an indication of the severity of the inflammation and/or damage to the liver. A low viral load can cause as much (or more) inflammation as a high viral load.
Liver damage
Prior to treatment, your HCP will need to know how much damage the hep C infection has caused to the liver. This is accomplished with blood tests and imaging tests, though biopsies may be used in some cases. The guidelines for treatment are sometimes different for people with cirrhosis of the liver, who may require treatment from a different specialist.
Deciding on a treatment
When deciding on a treatment plan for hepatitis C, your HCP will also consider other important factors about your health. These include:
- Whether you have been treated for hep C before
- Whether you have had a liver transplant
- Whether you have any other health conditions; there is overlap between hepatitis C and other blood-borne viruses, including HIV and hepatitis B
- Your overall health
If you have been diagnosed with hepatitis C, it is important to work closely with your HCP, get the tests you need, and follow your treatment plan.
